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| http://dx.doi.org/10.1159/000416901 | DOI Listing |
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Information needs in vascular access decision-making: A qualitative study of patient and clinical stakeholder perspectives.
J Vasc Access
January 2025
Glasgow Renal and Transplant Unit, Queen Elizabeth University Hospital, Glasgow, UK.
Background: The information and decision support needs required to embed a patient-centred strategy are challenging, as several haemodialysis vascular access strategies are possible with significant differences in short- and long-term outcomes of potential treatment options. We aimed to explore and describe stakeholder perspectives on information needs when making decisions about vascular access (VA) for haemodialysis.
Methods: We performed thematic analysis of seven (six online, one in person) focus group discussions including transcripts, post-it phrases and text responses with 14 patients and 12 vascular access professionals (four nephrologists, three surgeons and five nurses - Vascular access nurse specialists/Education and dialysis nurses) who participated in at total of six online and one in person focus group.
Endovascular Preparation With Innovative Custom-Made Stent-Graft Before Kidney Transplantation: The Solution for Patients With Hostile Iliac Calcification.
Transpl Int
January 2025
Service d'Urologie et de Transplantation, Hospices Civils de Lyon, Lyon, France.
The increasing age of patients with end-stage renal disease raises the issue of hostile arterial access for transplantation, with technical difficulties associated with clamping and suturing the iliac artery. Some of these patients - who theoretically represent those who would benefit the most from transplantation in terms of mortality - are contraindicated because of anatomical and medical issues. In this context, a specific endovascular device called EndoPreKiT (Endovascular Preparation for Kidney Transplantation) has been designed, enabling arterial access for transplantation via a mini-invasive procedure.
View Article and Find Full Text PDFA novel technique for external iliac artery reconstruction in renal transplant patients with extensively atherosclerotic lower limb vasculature.
J Vasc Surg Cases Innov Tech
April 2025
Department of Cardiovascular Surgery, Houston Methodist Hospital, Houston, TX.
We describe a 54-year-old man with type 2 diabetes mellitus, ischemic myopathy, pulmonary hypertension, and end-stage renal disease who was admitted for heart failure and listed for a dual cardiac-renal transplantation. Extensive calcification in the iliac arteries prevented clamping. Proximal endovascular balloon control of the left iliac artery was achieved using contralateral access; distal control was established by passing a Fogarty catheter distally through an iliac arteriotomy, later used for anastomosis of the cadaveric conduit.
View Article and Find Full Text PDFExamining the Clinical Significance and Embryologic Development of Two Unique Cases of Renal Anatomy.
Cureus
December 2024
Department of Surgery, Center for Anatomical Science and Education, Saint Louis University School of Medicine, Saint Louis, USA.
Two unique presentations of renal anatomy were observed during routine cadaveric dissection. The first case presented with an ectopic malrotated left kidney supplied by supernumerary renal arteries. This kidney was drained by a circumaortic renal vein and an inferior polar vein.
View Article and Find Full Text PDFMetabolic Characterization of Deceased Donor Kidneys Undergoing Hypothermic Machine Perfusion Before Transplantation Using C-enriched Glucose.
Transplant Direct
January 2025
Department of Metabolism and Systems Science, School of Medical Sciences, College of Medicine and Health, University of Birmingham, Birmingham, United Kingdom.
Background: The provision of a metabolic substrate is one mechanism by which hypothermic machine perfusion (HMP) of kidneys provides clinical benefit. This study aimed to describe metabolism in ex vivo human kidneys undergoing HMP before transplantation using C-labeled glucose as a metabolic tracer.
Methods: Cadaveric human kidneys were perfused with modified clinical-grade perfusion fluid (kidney perfusion solution [KPS-1], Organ Recovery Systems), in which glucose was uniformly enriched with the stable isotope C ([U-C] glucose).
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